'Life's much easier': Coming out can lower stress, ease depression

Carlo Joyce, right, and Thomas Joyce share a moment on their wedding day on July 10, 2010.

As a teenager, Carlo Joyce’s relationship with his parents was strained. He’s gay, but hid that fact from family and most of his friends. So he usually found himself lying when his folks asked where he was going and with whom.

“After I came out at 19, things got better with my family,” he recalled. But then he joined the Marines and had to hide his sexuality all over again.

He had to go to strip bars to fit in, and when the other guys talked about sex, or dating, he had to be sure he changed the gender in his stories. “It was very stressful to live that double life,” he explained. “I always had to watch what I said.”

Now, in a study released today in the journal Psychosomatic Medicine, a team of psychologists and neurologists from McGill University and the University of Montreal has found that leading that double life affects physical and mental health. Gays, bisexuals and lesbians who disclosed their sexuality to family, friends and co-workers were psychologically healthier and had lower levels of a key stress-related hormone than those who were still “in the closet.”

That finding could help explain a remarkable study published last year by a group of researchers from Columbia University in the American Journal of Public Health. They found that after Massachusetts enacted its same-sex marriage law in 2003, there was a significant drop in medical and mental health care visits -- and therefore costs – incurred by gay men.

Lead author of the Montreal study, Robert-Paul Juster, a PhD student at the Centre for Studies on Human Stress at the University of Montreal, said “it seems to be that if you’re using more avoidance coping, and wishful thinking, then you get poorer health. If you aren’t dealing with the problem, it affects health in a negative way.”

On the other hand, dealing with the problem by transitioning from “in” to “out” can instill a great sense of accomplishment. “A rebirth happens that makes them feel much more empowered and conscientious” for having taken what many see as a risky action. That sense of empowerment can have ripple effects benefitting overall health and well-being.

Juster’s study was complex. It included 87 people with a mean age of about 25, 46 of whom were lesbian, gay, or bisexual, and 41 of whom were heterosexual. There were slightly more men than women.

All the participants completed a battery of psychological testing to gauge traits like depressive symptoms, chronic stress, burnout, anxiety and conscientiousness. Blood samples were taken by the researchers, and the participants collected their own urine and saliva at five time points each day for two consecutive days. These were tested for a series of 21 biomarkers related to immune function, metabolism, inflammation, the cardiovascular system, and the endocrine system.

When all the numbers were sifted, and differences like social and economic status were controlled for, it turned out that disclosed sexual minorities had fewer symptoms of depression.

They also had lower cortisol levels 30 minutes after waking. That’s important because cortisol, a key stress hormone, spikes about half an hour after we wake up, like an ignition spark getting us ready to face the day. But you don’t want too much or too little. Disclosed gay men and lesbians were just right. In fact, dislcosed gay men also had lower cortsone levels than straight men.

Juster isn’t sure why, exactly. It could be because the gay men were in better physical shape. It could also be that because heterosexual men have never had to go through the stress of living life undercover, they’re less practiced at coping and so less resilient to life’s stress.

Joyce, now 33, and living in San Diego, has had a lot of practice. He’s an engineer at a large corporation. When he first started that job, he again hid his sexual orientation, from co-workers and bosses.

“It was like I was back in the closet,” he said. The hiding was self-imposed, but stressful all the same. “Once I did come out, it was much less stressful and I found great acceptance and support.” When he married his partner, many of his co-workers attended. (To clarify, the July 10, 2010, wedding was not a legal marriage as recognized by the state.) “Life’s much easier,” he said.